The National Task Force on Stem Cell Therapy Treatment, which comprises a group of respected doctors, with influence from the archdiocese, proposed to the Minister of Health, Dr. Perry Gomez calling for an overhaul of existing legislation concerning medical tourism in the Bahamas. Stem Cell research and therapy has the potential to generate over $100 million in the medical tourism industry, according to the government’s task force, which delivered its verdict on the country’s proposed plunge into the controversial science yesterday. “We put together the framework for stem cell work to be carried out to the benefit of Bahamians in an ethical way and to support the potential for a medical tourism industry, and we delved into the specifics of what can be done and what should not be done.” said Dr Arthur Porter.

-DG

The National Task Force on Stem Cell Therapy Treatment has recommended to the Bahamas Government that embryonic stem cells should not be used to create human stem cells in this country, said the Task Force’s chairman and managing director of the Cancer Centre, Professor Arthur T. Porter.

Professor Porter presented a copy of the Task Force’s recommendations to Minister of Health the Hon. Dr. Perry Gomez during a press conference held at the Ministry of Health, Thursday, December 27, 2012. The Chairman told Dr. Gomez that the Task Force’s members unanimously support all of the recommendations within the report.

In November 2012, the Bahamas Government appointed the Task Force to develop a series of recommendations regarding the possible use of Stem Cell Therapy in The Bahamas. The Committee had to weigh all the pros and cons associated with Stem Cell use, including the more controversial use of embryonic Stem Cells. The Task Force also had to look at how adult Stem Cells would be used.

Dr. Wesley Francis, President of the Medical Association of The Bahamas; Dr. Glen Beneby, Medical Director, Public Hospitals Authority and Mrs. Michelle Pindling-Sands, Attorney-at-law, also sit on the Task Force. When the Task Force was first introduced, Professor Porter explained that there are two types of stem cells.

“Embryonic cells usually derive from a five-day embryo or earlier, which have the ability to become any cell in the body whether a brain cell, a fat cell or a nerve cell. They are pluripotent (capable of differentiating into one of many cell types).

“The second type are the adult stem cells, which are smaller in quantity and can be found in most tissue and organ systems, but which lack the flexibility of what they can be, and so scientist have tried to take some of the adult Stem Cells and make them able to be more or less like embryonic stem cells to sort of get around the problem.” Professor Porter explained that during the Task Force’s deliberations, it was found that there is no need for the use of embryonic Stem Cells, because research is finding that adult Stem Cells can be transformed to be able to act as Induced Pluripotent Stem Cells. As a result, he said there is no need to focus on embryonic stem cells in The Bahamas.

Professor Porter said the use of umbilical cord blood, which has been used for over 15 years in different parts of the world, should also be permitted in The Bahamas. “The use of somatic cell nuclear transfer, which is a type of technique in which adult Stem Cells are encouraged to behave, as early Stem Cells should also be used. “But again recognizing that we are on the frontiers of new science, so the appropriate clinical trials, the appropriate committees, the appropriate ethics support should be given to the use of these areas.”

Professor Porter said many have asked the Task Force for an opinion regarding reproductive human cloning. “The Task Force was quite committed in its opinion that reproductive cloning should not be permitted.” He added that the Task Force felt that it was important that there be widespread education and consultation with various stakeholder groups that will be involved in making the ultimate decision, so people would become aware of the importance of Stem Cells, some of the ethical issues and be able to opine in this regard. Professor Porter said the Task Force believed that Stem Cells would be an important part of the country’s medical tourism thrust, but the Government needs to broadly review what is necessary for a successful medical tourism industry. Dr. Sands added, “We have to understand that this is a rapidly evolving field and there are many countries in the world that have embraced medical tourism and as such have tried desperately to ensure the process of approval or the rapid acceleration of new projects is done in a timely fashion. “Similarly, efforts have been made to ensure that phenomenal scrutiny of the proposed projects, the participants, etc., is carefully done.

He said legislation in The Bahamas has to be robust enough to protect the integrity and the reputation of the country while at the same time promoting good science and this is an on-going process. “We need to make sure the laws are constantly keeping up with what is happening on the ground.” Dr. Gomez said after he reviews the report, he would present it to Cabinet early next year so that policies can be made surrounding Stem Cell Therapy in the country.

“…the key to repairing injured tissue does not hinge on where you place the MSC cells in the body, but on learning exactly how the MSC cells recruit their counterparts already in the body.” Mesenchymal stem cells use signals to trigger the body’s own stem cells to heal wounds and this discovery could be used to develop treatments based on controlling these signals.

-DG

Durham, NC — Mesenchymal (MSC) stem cells send out “homing signals” that recruit other stem cells and mobilize them to heal wounds, researchers at the Chicago Medical School at Rosalind Franklin University of Medicine and Science have discovered. MSC stem cells are better suited to initiating the healing process rather than repairing tissue damage themselves, the researchers explain in an article in the current issue of STEM CELLS Translational Medicine.

Scientists Daniel Peterson and Laura Shin used MSC cells extracted from human bone marrow and grafted them into wounds of healthy mice and mice with diabetes. Mice in both groups each had two separate wounds to better allow the researchers to study the precise role the cells played in healing. Some mice in each group received MSC cells in one wound while others did not receive the cells at all.

After studying the differences in healing, signaling and cell populations in the mice, Peterson and Shin learned that both normal and impaired mice given MSC cells healed more quickly, even in wounds that did not receive direct MSC cell grafts. “The mice that received MSC cells demonstrated a systemic response,” Peterson said. “This suggests that the key to repairing injured tissue does not hinge on where you place the MSC cells in the body, but on learning exactly how the MSC cells recruit their counterparts already in the body.”

Researchers have investigated the behavior of MSC cells in a wide range of clinical trials including studies related to Crohn’s disease, Type 1 diabetes, bone defects and heart muscle disease. However, although MSC cells have come to be regarded as a “magic bullet” for tissue repair, no one until now has been able to explain how they do the job. Discovering more about the signals MSC cells use to trigger the body’s own stem cells to heal could lead to new cell-free therapies, Peterson said. For example, scientists could develop treatments using small molecules or drugs as an alternative to costly cell-mediated therapies.

“These findings broaden our view of therapeutic targets to include the host response,” he said. “The improvement in impaired and normal wound healing has significant clinical relevance for all wounds, chronic and acute. This study indicates that signals within the wound bed may be activated after engraftment, suggesting that controlling mobilization is a key to success in future therapies,” said Anthony Atala, MD, Editor of Stem Cells Translational Medicine and director of the Wake Forest Institute for Regenerative Medicine.

This has been suggested before, but the new report leaves no question of the ethical issue. To justify its continuation in some form, perhaps as a nonprofit or a foundation, the agency needs a majority of independent board members to make funding decisions.

The stem cell institute’s public funding window closes in 2014. It commissioned the review in part to help figure out how it might survive after that to sustain progress in stem cell research.

Even if there were no concerns about independence, another voter-approved bond would be out of the question.

Long-term funding was never the intent when Proposition 71 passed in 2004. It was supposed to kick-start research at a time when federal funding was blocked and to establish California as a major player in the rapidly advancing medical field.

A significant step discovered in the fight against Type 1 diabetes. An Australian team of scientists and researchers led by Dr. Ilia Banakh and Professor Len Harrison have developed a technique to manipulate isolated stem cells for the adult pancreas to become insulin-producing beta cells capable of producing insulin in response to glucose. “The discovery could bring closer the time when people with type 1 diabetes will be able to produce their own insulin and be free of the multiple daily injections”.

-DG

The discovery was made by scientists from the Walter and Eliza Hall Institute and provides further evidence that stem cells don’t only occur in the embryo.

The ability to produce the hormone insulin is crucial for controlling blood sugar (glucose) levels. In people with type 1 diabetes the body’s immune system destroys the insulin-producing beta cells of the pancreas, leading to a potentially fatal elevation of blood glucose levels. People with type 1 diabetes rely on multiple daily injections of insulin, or an insulin infusion pump, to control their blood glucose, but control is not perfect and they are at risk of serious long-term health complications.

Dr Ilia Banakh and Professor Len Harrison from the institute’s Molecular Medicine division have not only identified and isolated stem cells from the adult pancreas, but developed a technique to drive these stem cells to become insulin-producing cells that can secrete insulin in response to glucose.

Professor Harrison said that insulin-producing cells had previously been generated from cells in the adult pancreas with ‘stem cell-like’ properties. “But what Dr Banakh has done is pinpoint the cell of origin of the insulin-producing cells and shown that the number of these cells and their ability to turn into insulin-producing cells increases in response to pancreas injury. This is exciting, because it means that the potential to regenerate insulin-producing cells is there in all of us, even as adults,” Professor Harrison said.

“In the long-term, we hope that people with type 1 diabetes might be able to regenerate their own insulin-producing cells. This would mean that they could make their own insulin and regain control of their blood glucose levels, curing their diabetes. Of course, this strategy will only work if we can devise ways to overcome the immune attack on the insulin-producing cells, that causes diabetes in the first place,” Professor Harrison said.

“Scientists have been successfully deriving stem cells from ordinary human cells for years. Researchers have reprogrammed testicle stem cells to make insulin and even harvested adult stem cells from the scalps and brain linings of human corpses. A recent study published in the journal Natural Methods, showcases the ability to take kidney cells that are shed and excreted through urine and transform them into brain stem cells, without the unpredictable threat of tumors when transplanted to the host. This new method could be useful in treating neurodegenerative diseases, such as Parkinson’s and Alzheimer’s.”

-DG

The technique is described in a study that was published in the journal Nature Methods (Wang, et al., Nature Methods (2012) doi:10.1038/nmeth.2283). Unlike embryonic stem cells, which are derived through the destruction of embryos and have the potential to cause tumors, these neural progenitor cells do not form tumors and are made quickly and without the destruction of human embryos.

Stem cell biology expert Duanqing Pei and his co-workers from China’s Guangzhou Institutes of Biomedicine and Health, which is part of the Chinese Academy of Sciences, previously published a paper that showed that epithelial cells from the kidney that are sloughed into urine can be reprogrammed into induced pluripotent stem cells (iPSCs) (Ting Zhou, et al.,Journal of the American Society of Nephrology 2011 vol. 22 no. 7 1221-1228, doi: 10.1681/ASN.2011010106). In this study, Pei and his colleagues used retroviruses to insert pluripotency genes into kidney-based cells to reprogram them. Retroviruses are efficient vectors for genes transfer, but they insert their virus genomes into the genomes of the host cell. This insertion event can cause mutations, and for this reason, retroviral-based introduction of genes into cells are not the preferred way to generate iPSCs for clinical purposes.

Researchers use retroviruses to routinely reprogram cultured skin and blood cells into iPSCs, and these iPSCs can be differentiated into any adult cell type. However, urine is a much more accessible source of cells.

In this present study, Pei’s team used a different technique to introduce genes into the cells from urine; they used “episomal vectors,” which is an overly fancy way of saying that they placed the pluripotency genes on small circles of DNA that were then pushed into the cells. Episomal vectors can reprogram adult cells into iPSCs, but they do so at lower levels of efficiency. Nevertheless, episomal vectors have an added advantage in that the vectors transiently express the pluripotency genes in cells and then are lost without inserting into the host cell genome. This makes episomal vectors inherently safer for clinical purposes.

In one of their experiments, perfectly round colonies of reprogrammed cells from urine that resembled pluripotent stem cells after only 12 days. This is exactly half the time typically required to produce iPSCs. When cultured further, the colonies assumed a rosette shape that is common to neural stem cells.

When Pei and others cultured his urine-derived iPSCs in a culture conditions that normally used for cultured neurons, these cells formed functional neurons in the lab. Could these cells work in the brain of a laboratory animal? Transplantation of these cells into the brains of newborn rats showed that, first of all, they did not form tumors, and, secondly, they took on the shape of mature neurons and expressed the molecular markers of neurons.

The beauty of this experiment is that neural progenitors cells (NPCs) grow in culture and researchers can generate buckets of cells for experiments. However, when cells are directly reprogrammed to neurons, even though they make neurons faster than iPSCs.

James Ellis, a medical geneticist at Toronto’s Hospital for Sick Children in Ontario, Canada who makes patient-specific iPSCs to study autism-spectrum disorders, said: “This could definitely speed things up.”

Another plus of this study is that urine can be collected from nearly any patient and banked to produce instant sources of cells from patients, according to geneticist Marc Lalande, who creates iPSCs to study inherited neurological diseases at the University of Connecticut Health Center in Farmington. Lalande is quite intrigued by the possibility of making iPSCs and NPCs from urine draw from the same patient. Lalande added: “We work on childhood disorders,” he says. “And it’s easier to get a child to give a urine sample than to prick them for blood.”

Millions of people in the United States suffer with type 1 diabetes and are unable to produce sufficient insulin. “As of 2010, 25.8 million people—8.3% of the population—have diabetes; 1.9 million new cases of diabetes were diagnosed in people aged 20 years or older in 2010.” (http://www.cdc.gov/diabetes/consumer/research.htm) “… About 27 percent of those with diabetes—7 million Americans—do not know they have the disease. Pre-diabetes affects 35 percent of adults aged 20 and older. (http://www.cdc.gov/media/releases/2011/p0126_diabetes.html) The potential to transplant insulin-producing cells into patients suffering from Diabetes would be a critical step forward and could offer hope for a long-term cure.
-DG

The potential to one day treat type 1 diabetes using transplants of insulin-producing beta-cells derived from pancreatic progenitors may have just crept a tad closer, if findings by a group of researchers at the University of California, San Diego (UCSD) can be verified. The team has identified a cell surface marker on a subpopulation of cells in the pancreas that appears to identify them as pancreatic stem cells (PnSCs), a cell type which has never actually been firmly demonstrated in human or animal tissues.

A current approach to cell replacement therapy for diabetes involves the transplantation of pancreatic islets, which involves numerous transplant procedures. Although it is feasibly possible to derive insulin-producing cells from either human embryonic stem cells (hESCs) or induced pluripotent stem cells (iPSCs), there are technical issues which have yet to be solved. What is ideally needed is a source of stem cells derived directly from the pancreas that can readily be prompted to differentiate into the desired cell type.

Research by Alberto Hayek, Ph.D., and colleagues now indicates that human pancreatic ductal cells that express the cell surface stem cell marker stage-specific embryonic antigen 4 (SSEA4) may represent this elusive population of PnSCs that has long been postulated but never quite isolated. The cells, located in the exocrine portion of the adult human pancreas but not inside islets themselves, also express ductal, pancreatic progenitor, and stem cell protein markers. Interestingly, the investigators found that SSEA4-expressing cells isolated from fetal pancreatic tissue additionally express a recognized marker of endocrine progenitor cells.

Notably, when the UCSDF team then isolated adult human pancreatic SSEA4+ cells and cultured them in media containing high levels of glucose and B27 supplements, the cells formed aggregate-like spheres and differentiated readily into pancreatic hormone-expressing cells.
“Accumulated evidence supports the concept that pancreatic stem/progenitor cells may originate in the pancreatic duct, where they reside in a quiescent stage,” the authors remark. “We are first to identify SSEA4+ cells in the adult human pancreas with characteristics of pancreatic progenitors. Further clonal analysis would confirm their stemness…. The discovery of specific markers for the identification and purification of human PnSCs would greatly facilitate studies aimed at the expansion of these cells and the development of targeting tools for their potential induction to insulin-producing cells.

Scientists at Children’s Hospital Oakland Research Institute (CHORI) led by Vladimir Serikov, MD, PhD, and Frans Kuypers, PhD, report in the current Epub issue of Stem Cells Translational Medicine that placental stem cells with important therapeutic properties can be harvested in large quantities from the fetal side of human term placentas called the chorion.

The chorion is a part of the afterbirth and is normally discarded after delivery, but it contains stem cells of fetal origin that appear to be pluripotent — i.e., they can differentiate into different types of human cells, such as lung, liver, or brain cells. Since these functional placental stem cells can be isolated from either fresh or frozen term human placentas, this implies that if each individual’s placenta is stored at birth instead of thrown away, these cells can be harvested in the future if therapeutic need arises. This potential represents a major breakthrough in the stem cell field.

In previous work, Drs. Serikov and Kuypers reported a novel technology to harvest blood-forming stem cells from the placenta to augment cord blood cells. These cells are “siblings” of the cord blood derived stem cells. Cord blood stem cells, unlike embryonic stem cells, have been used for many hundreds of successful bone marrow transplants. These transplants are mainly performed in children, as the amount of cells that can be harvested from cord blood is usually not sufficient for a successful transplant in adults. Adding placental-derived stem cells to the cord blood stem cells could make successful adult bone marrow transplants routinely possible.

The current report demonstrates that placental stem cells have much broader therapeutic potential than bone-marrow transplants, because they are pluripotent — i.e. able to differentiate into many different cell types — and they also generate growth factors that help in tissue repair. These cells are shown to integrate into different tissues when transplanted into mice, but like cord blood stem cells, and in contrast to embryonic pluripotent stem cells, they do not form tumor-like structures in mice.

Placental-derived stem cells are often viewed as “adult” stem cells in contrast to “embryonic” stem cells, which are the dominant focus in the stem cell research field. However, this report shows that these fetal stem cells can be harvested in large numbers, and without the ethical concerns attached to the use of embryonic stem cells. These stem cells may thus be a more practical source for regenerative medicine, particularly since, if placentas are routinely saved instead of thrown away, each individual will be able to draw on their own fetal stem cells if future therapeutic needs arise.

Placental stem cells are only 9 months old, and in contrast to adult stem cells, do not need to be reprogrammed to become pluripotent. Placental-derived stem cells have characteristics of young and vigorous cells, including young mitochondria. Future research will be aimed to bring this to the clinic and to test their efficacy in translational therapeutic applications.

Cancer survivors, who have undergone radiation or chemotherapy treatments, are often met with the dismal reality of infertility. Oncologists, for years, have been unable to address the long-term and permanent consequences of these life saving treatments. New research conducted on the concept of using spermatogonial stem cells to restore fertility has proven to be a success in male primates and is getting closer to clinical trials.

-DG

A UTSA professor has now demonstrated that it is possible to remove testicular stem cells from a monkey prior to chemotherapy, freeze them and later, after cancer treatments, transplant these cells where they can restart sperm production and restore fertility. UTSA Assistant Professor Brian Hermann worked in collaboration with researchers at the University Of Pittsburgh School Of Medicine Magee-Women’s Research Institute (MWRI) on a technique that might be used to make male cancer patients fertile using their own spermatogonial stem cells.

“This is a really exciting milestone for this research,” said John McCarrey, director of the San Antonio Cellular Therapeutics Institute. “This is the first time that anybody has been able to show the concept works in a primate model, and that is an important step in moving the research forward to clinical trials.”

While men facing cancer treatments, which could cause infertility, are able to store their own sperm for future use in the fertility clinic, this is not an option for boys before puberty who are not yet making sperm. But, all pre-pubertal boys have spermatogonial stem cells (SSCs) in their testes, which could be used for transplantation. The concept of using spermatogonial stem cells to restore fertility was first introduced in the mid-1990s by University of Pennsylvania scholar Ralph L. Brinster. Since that time, scholars have been working to demonstrate the concept is viable. But, more work is required. The research must overcome a number of hurdles before it can become a common clinical practice. “This research demonstrates the proof of principle — that the concept works in primates and has a good chance of working in humans,” said Hermann. “We need to better understand the optimal timing of transplantation, how to prepare testicular stem cells for transplantation and make them safe for transplantation, and how to maximize their ability to restart sperm production.” But, it’s difficult for researchers to know when clinical trials will begin, since the removal and storage of spermatogonial stem cells currently is a rare practice worldwide.

“There are currently only a handful of clinics around the world that will remove and preserve testicular stem cell samples from pre-pubertal patients, and that limits the availability of candidates,” said Hermann. “Until more clinics get on board and save stem cells for patients, we are limited in what we can do to test transplantation in clinical trials.”

Hermann joined the UTSA College of Sciences faculty in summer 2011, following a post-doctoral fellowship at MWRI alongside Associate Professor Kyle Orwig. At UTSA, he is continuing to focus his research on basic and translational studies of spermatogonial stem cells to preserve fertility in boys treated for cancer and related diseases. “For a long time, oncologists have been unable to address the long-term consequences of life-saving chemotherapy and radiation treatments such as infertility,” said Hermann. “That is now beginning to change as laboratory research such as this study provides new experimental options for patients facing infertility after cancer.”

A new ground-breaking study was performed at Northwestern University focused on ridding Kidney transplants patients of the arduous task of the “never-ending” anti-rejection medications. Dr. Joseph R. Leventhal and his team successfully created chimerism (two immune systems in the same recipient) which eliminates the need for anti-rejection medications within six months to a year of the surgery.

“The results have been remarkable…It may reshape the landscape of how we perform transplants over the next decade”, said Dr. Leventhal.

People whose kidneys are failing can wait years to get a transplant. About one in 20 will die during that wait. New kidneys offer transplant patients a second chance at life. But what they have to do for the rest of their lives is a big concern to many. “The thing that scared me the most about the transplant wasn’t the operation,” said Lindsay Porter, who had polycystic kidney disease. Porter’s kidneys had swelled to eight pounds apiece “At the end, I was wearing maternity clothes,” she said. She had PKD, or polycystic kidney disease, and needed a transplant. She wasn’t scared of the surgery, but something did frighten her. “It was really the medications,” said Porter. She feared the anti-rejection drugs she would have to take for the rest of her life and the other medications to help with the possible side effects of those drugs.

Lori Felber Knows All About That. Nine pills a day–3285 pills a year. That’s what she’s had to take since her kidney transplant in 2008. Felber is grateful her husband was able to save her life by donating his kidney, but not for having to take these expensive drugs all the time. But today, Porter’s doesn’t have to. “I take nothing, nothing,” she said. She took part in a pioneering study at Northwestern University. It involved 18 kidney transplants, where the unmatched, unrelated donors gave more than kidneys to the recipients. They also gave their stem cells. “The results have been remarkable,” said Joseph R. Leventhal, MD, PhD, Associate Professor of Surgery and Director of Kidney and Pancreas Transplantation at Northwestern University. Dr. Leventhal heads up the study. He says the idea is to create chimerism, or two immune systems in the recipient. Joseph R. Leventhal, MD, PhD, “So, you have peaceful co-existence, if you will, of the donor’s stem cells with the other aspects of the recipient’s immune system,” said Dr Leventhal. To make that happen, Porter had chemotherapy and radiation before the transplant, to weaken her own immune system. The day after her transplant, engineered stem cells from her donor were infused into Porter’s body. Days later, one more chemo session was given. While she started off on the full regimen of anti-rejection drugs, “I was on the medications for about six months before they started weaning me off of it,” said Porter. Unlike Felber, who faces a lifetime of medications and potential side effects, Porter was off all the drugs after just one year. Dr. Leventhal says most recipients who went through the procedure had similar results. While there was a risk of the injected stem cells reacting against their bodies, none experienced that. “It may reshape the landscape of how we do transplant over the next decade,” said Dr. Leventhal. With a healthy kidney and no more anti-rejection drugs to take, Porter’s free to spend her time with her son “I’m so glad that I’ve had the last two years to really be with him 100%,” she said. Porter said the procedure cured her of her high blood pressure, and her blood type changed to the blood type of her donor. The transplant study she was involved in is ongoing. A second trial is also being planned. It will offer a similar treatment to people, like Felber, who’ve already undergone a living donor kidney transplant.

BACKGROUND:
TRANSPLANTATION: Organ transplantation is the surgical removal of an organ or tissue from one person and putting it another. Organs that can be donated include the kidney, heart, liver, lung, pancreas, and intestine, but tissues such as bone, cartilage, and the cornea can also be transplanted. With about 4,100 transplant candidates added to the national waiting list each month, the number of people in need of a transplant is rising faster than the number of donors. Although around 77 people a day receives transplants, there are also about 18 that die waiting due to the shortage of donated organs. (Source: http://www.womenshealth.gov)
CARE AFTERWARDS: After a transplant, most people need to take a lot of medications. These medications include immunosuppressants, which stops the body from rejecting the organ. Other than the annoyance of having to take multiple pills for the rest of their lives, the immunosuppressants may also make the person more likely to get infections and make it harder to recover from some infections and illnesses. Patients will continue to have their health monitored by their doctor for many years after the surgery as well. (Source: http://www.womenshealth.gov)

DONATION: Most of the donated organs and tissues come from people that have already died but living people can donate a kidney or a part of their liver, intestine, pancreas, and lung as well. Becoming an organ donor is a personal decision and there are many reasons why some people decide not to donate. For living donors, the operation can be risky and for those who have died, religious views may stand in the way. Disease or a medical condition will not exclude a person from donating, but here are some medical conditions that mean a person cannot donate:
1. HIV
2. Actively spreading brain cancer
3. Certain severe, current infections (Source: http://www.womenshealth.gov)

NEW TRANSPLANT THEORY: The new clinical trial by researchers from Northwestern Medicine and the University of Louisville is hoping to ‘trick’ the recipient’s immune system into thinking that the transplanted organ is a part of the patients natural self so the need for anti-rejection medication will be reduced or eliminated gradually. A month before the transplant, bone marrow stem cells are collected from the kidney donor’s blood, then sent to the University of Louisville where researchers enrich for “facilitating cells” believed to help transplants succeed. At the same time, the recipient undergoes chemotherapy and radiation to suppress bone marrow in order to make room for the donor’s stem cells to grow. The day after the transplant, the donor’s stem cells are put into the recipient and hopefully the two systems exist and function in one person. So far, results have been good. (Source: http://www.northwestern.edu)

A team of engineers at the University of Sheffield have developed a new approach to treating humans who have sustained damage to the cornea. The procedure entails grafting a biodegradeable disc, filled with stem cells, to the host’s cornea. “The aim is to effect the natural repair of eyes damaged by accident or disease, enabling millions of people across the world to retain – or even regain – their sight.”

-DG

In research published in the journal Acta Biomaterialia, the team describes a new method for producing membranes to help in the grafting of stem cells onto the eye, mimicking structural features of the eye itself. The technology has been designed to treat damage to the cornea, the transparent layer on the front of the eye, which is one of the major causes of blindness in the world.

Using a combination of techniques known as microstereolithography and electrospinning, the researchers are able to make a disc of biodegradable material which can be fixed over the cornea. The disc is loaded with stem cells which then multiply, allowing the body to heal the eye naturally.

“The disc has an outer ring containing pockets into which stem cells taken from the patient’s healthy eye can be placed,” explains EPSRC Fellow, Dr Ílida Ortega Asencio, from Sheffield’s Faculty of Engineering. “The material across the centre of the disc is thinner than the ring, so it will biodegrade more quickly allowing the stem cells to proliferate across the surface of the eye to repair the cornea.”

A key feature of the disc is that it contains niches or pockets to house and protect the stem cells, mirroring niches found around the rim of a healthy cornea. Standard treatments for corneal blindness are corneal transplants or grafting stem cells onto the eye using donor human amniotic membrane as a temporary carrier to deliver these cells to the eye. For some patients, the treatment can fail after a few years as the repaired eyes do not retain these stem cells, which are required to carry out on-going repair of the cornea. Without this constant repair, thick white scar tissue forms across the cornea causing partial or complete sight loss. The researchers have designed the small pockets they have built into the membrane to help cells to group together and act as a useful reservoir of daughter cells so that a healthy population of stem cells can be retained in the eye.

“Laboratory tests have shown that the membranes will support cell growth, so the next stage is to trial this in patients in India, working with our colleagues in the LV Prasad Eye Institute in Hyderabad,” says Professor Sheila MacNeil. “One advantage of our design is that we have made the disc from materials already in use as biodegradable sutures in the eye so we know they won’t cause a problem in the body. This means that, subject to the necessary safety studies and approval from Indian Regulatory Authorities, we should be able to move to early stage clinical trials fairly quickly.”

Treating corneal blindness is a particularly pressing problem in the developing world, where there are high instances of chemical or accidental damage to the eye but complex treatments such as transplants or amniotic membrane grafts are not available to a large part of the population.

The technique has relevance in more developed countries such as the UK and US as well, according to Dr Frederick Claeyssens. “The current treatments for corneal blindness use donor tissue to deliver the cultured cells which means that you need a tissue bank. But not everyone has access to banked tissues and it is impossible to completely eliminate all risks of disease transmission with living human tissue,” he says. “By using a synthetic material, it will eliminate some of the risk to patients and be readily available for all surgeons. We also believe that the overall treatment using these discs will not only be better than current treatments, it will be cheaper as well.”

The research is supported by a Welcome Trust Affordable Healthcare for India Award to the University of Sheffield and the LV Prasad Eye Institute, where the work is led by Associate Director and Head of Clinical Research, Dr Virender Sangwan. The work has also been supported through a Research Fellowship for Dr Ortega from the Engineering and Physical Sciences Research Council (EPSRC).